Doctor, am I fit to fly?

(Air Travel in Pregnancy)

Air travel is no longer a luxury but a necessity for many. One of the frequent concerns of our
pregnant mothers is whether they are permitted to fly.
This document will encompass:
A) Local airline guidelines on gestation during travel
B) Problems with flying for the mother
C) Patients not suitable to fly
A) Local airline guidelines on gestation during travel
Malaysia Airlines
The following groups of patients may be refused carriage:
1) Multiple pregnancies after 32 weeks
2) Singleton pregnancies after 35 weeks for international flights
3) Singleton pregnancies after 36 weeks for domestic sectors
4) Until 7 days after delivery
Airasia
1) Up to 27 weeks (inclusive)
-Doctors certification not required. Guest must sign Limited Liability Statement
2) 28-34weeks (inclusive)
- Submission of an approved doctor's medical certificate required.
- Doctor's medical certificate confirming the number of weeks of pregnancy and the certificate shall
be dated not more than thirty (30) days from either the scheduled outbound or the scheduled
inbound flight departure date as the case may be.
-Guest must sign Limited Liability Statement at the time of check-in
3) 35 weeks and above-Airasia will refuse carriage
B) Problems with flying to the mother
1) Radiation
-This may be increased due to cosmic radiation during flight or ionizing radiation from body scanners
-Both are considered to have insignificant doses absorbed by the mother and fetus

2) Lower cabin pressure and lower humidity

- Decrease in partial pressure of oxygen and saturation. Healthy pregnant women should not be
affected.
-Increased insensible losses may be secondary to a lower humidity. However, there is no evidence
that dehydration occurs
3) DVT
-3 fold increase in risk of DVT BUT the absolute risk is still low
-Flights longer than 4 hours places the patient at increased risk
-Patients should be advised to choose an aisle seat, adequate fluid intake, avoidance of
caffeine/alcohol to prevent dehydration, regular ambulation at 30 min intervals
- If additional risk factors are present, LMWH and TED stockings should be considered

C) Patients not suitable to fly

1) Severe anaemia Hb< 7.5 g/dl or recent sickling crisis
2) Unstable fracture, where significant leg swelling can occur in flight, particularly if a cast is in place
3) Recent haemorrhage
4) Otitis media and sinusitis
5) Serious respiratory disease, particularly with marked breathlessness
6) Recent gastrointestinal surgery where suture lines on the intestine could come under stress due
to the reduction in pressure and gaseous expansion
When dispensing advice with regards to air travel, special consideration must be given for the reason
of travel.
Source:
1) Respective airlines website
2) RCOG Information for you: Air travel and Pregnancy. Jan 2011
3) Scientific Impact Paper No.1 ( Draft) July 2012

Edited 16/10/12 LucasLuk;Voon HY